Saturday, July 02, 2016

Copious Rectal Bleeding

The clinical pastoral education roller coaster remains in full swing. On Monday, I felt that I hated this work and would definitely not continue past the end of the summer. I am more oriented. I almost remember which way to turn after exiting the elevator or stairwell and almost know which patient rooms are mine without looking at my list. Also, I’m getting a sense for which of my three areas has the patients with the most repulsive ailments.

Early in the week, this seemed to be shaping up to be a career-ending, or career-aborting, problem. If I myself had copious rectal bleeding requiring half a roll of toilet paper to sop up, then I would just be dealing with that moment by moment, and if I visit a patient with the same, no problem. But reading the words “rectal bleeding” in a chart, along with the details about the half a roll of toilet paper, makes me feel overwarm and queasy. It’s definitely a possibility just not to read charts (though we are supposed to), but it is helpful to know if a patient has dementia or if he or she can’t speak.

I suppose I’ll get used to the chart thing sooner or later. I have been looking up terms and acronyms so I can understand better what I’m reading, 95 percent of which is not disturbing in the way described above. What I was hating early in the week was having, almost without exception, one short conversation after the other all day long. I realized that I was asking a yes / no question (about whether spiritual or religious support was needed) and added an open-ended inquiry about how the person was doing, or how their day was going. That added about seven seconds to each conversation (two for me to ask the question and five for them to answer it). Continuing to experiment, after one patient answered that question, I let a silence arise, and then said, “Tell me more,” and the person did actually tell me more, so I am learning, slowly.

Toward the end of Monday, I kind of cheated and went to see a woman who I know doesn’t need anything from me, but who is guaranteed to talk for 20 minutes, due to dementia. M.I. is quite a charming person, 70 or so and lovely to look at. It was such a pleasure just to sit down, which I rarely do during the day, and listen to her chat about this and that. That was the high point of the day.

Samantha returned to the office on Monday after her week away, and when I first heard her voice behind me, I felt a wave of terror. I was saying here that I couldn’t think of one instance of being spoken to rudely at my former job—I had completely forgotten the part about being bullied by a particular person for six long years. There are interpersonal challenges anywhere you are.

On Tuesday, I had some positive interactions with Samantha and two good—at this point just meaning long—patient visits, including one with a palliative care patient. Palliative care is not the same thing as hospice, but generally a palliative care patient is dying. This patient was talking away in a rather jaunty manner, but I could see the look of terror in her eyes, and several times it appeared that she was tearing up. By nature, I like to ask a lot of questions, but asking questions causes people to think instead of feel, so I replied very minimally, just saying “Mmmm” after each time she spoke, and very soon she was musing on what happens after we die.

We learned that day that Samantha is pregnant with twins. Normally I disapprove of attributing women’s unpleasant behavior to hormones (“It must be that time of the month!”), but perhaps she does actually have raging hormones, or worries about how she and her husband will support three children—their first child is just one year old—on two do-gooder salaries.

Periodically I get an email from my ex-employer inviting me to apply for this or that job. It’s nothing personal, just matching job titles, but it feels good to get these, anyway. It’s odd that you can be a chaplain by merely doing some volunteer training and you can also be a chaplain by putting in an immense amount of effort spanning years. Maybe being a volunteer chaplain in retirement would be enough for me. Also, I really miss being at the soup kitchen.
Post a Comment